Trial tests use of email to motivate heart failure patients

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Can a patient’s inbox provide a way out from the burdens of chronic heart failure? A clinical trial in Canada is testing whether an e-consulting strategy will help patients adhere to self-care protocols without taxing the healthcare system.

Robert P. Nolan, PhD, of the Behavioral Cardiology Research Unit at Toronto General Hospital, and colleagues outlined the Canadian e-Platform to Promote Behavioral Self-Management in Chronic Heart Failure (CHF-CePPORT) trial in the January-March issue of the Journal of Medical Internet Research. The double-blind randomized controlled clinical trial will compare the use of an e-platform in adult patients with chronic heart failure with standard care. Their goal is to pilot test the strategy to determine whether it improves quality of life while reducing hospitalization and mortality.

To be eligible, patients must be older than 18, diagnosed with New York Heart Association Class II or III heart failure and a left ventricular ejection fraction of 40 percent or less. They will be recruited by cardiologists in Toronto, Montreal and Vancouver.

The e-counseling arm will receive 28 emails over 12 months that incorporate behavioral counseling techniques that include multimedia materials and interactive e-tools tailored to meet the patient’s readiness for change. The control arm also will receive emails but without tailored information or the e-tools. Otherwise, both groups will receive usual care.

Patients will be assessed at baseline, four months and one year. The primary outcome is improvement in quality of life, as measured by the Kansas City Cardiomyopathy Questionnaire. Nolan et al plan to use results to develop a phase 3 trial and to assist the Heart and Stroke Foundation of Canada in educational initiatives.